Multiple biopsy apparatus and related method of use

ABSTRACT

An endoluminal biopsy device is provided with a proximal actuation mechanism attached to a distal sampler by at least one elongate member. The distal sampler includes a distal inner portion defining a plurality of chambers, each configured to receive a tissue sample, and a distal outer portion defining a cutting mechanism opening having a cutting edge adjacent the cutting mechanism opening. The distal outer portion is configured so that, when the cutting mechanism opening aligns with one of the plurality of chambers, the distal outer portion covers the remaining chambers. A related method for the use of such an endoluminal biopsy device also is provided.

BACKGROUND OF THE INVENTION

[0001] 1. Field of the Invention

[0002] The present invention relates to a biopsy device for use inendoluminal procedures. More particularly, the present invention relatesto a biopsy device that is capable of taking multiple biopsies.

[0003] 2. Description of the Related Art

[0004] An endoluminal procedure is a medical procedure that takes placein one of the many tubes, or lumens, within the human body. Theseendoluminal procedures may take place in vascular, gastrointestinal, orair exchange lumens and may involve disease diagnosis and/or treatment.Millions of endoluminal procedures are performed each year in hospitalsaround the world.

[0005] Endoluminal procedures are often performed utilizing a deviceknown as an endoscope. An endoscope is a tube, either rigid or flexible,that is introduced through a lumen (opening) in the human body, such asthe mouth or rectum. The endoscope may simply be used to hold open thelumen for examination, but it may also carry light(s), visioningsystem(s), or other tools to be used in the procedure. An open or“working” channel is usually present within the endoscope into which theendoscopist can insert and withdraw a myriad of endoluminal diagnosticor treatment devices.

[0006] In some endoscopic procedures, biopsies (tissue samples) areobtained. Tissue samples can be examined in a laboratory to determinethe presence of a pathological disorder, such as a malignancy. Often thesample may need to be obtained from deep within the body cavity medicalsampling instruments. It is usually best to sample at various locationswhere the disorder is suspected so that the presence and progress of thedisease (if any) may be determined. The samples may need to becatalogued according to the location from which each sample is taken,and the integrity of the samples should be maintained for subsequent labanalysis.

[0007] Existing endoluminal devices are capable of taking multiplebiopsies without removing the device, but there are disadvantages to thedevices currently in use. Usually the device must be moved each time abiopsy is taken so that the location of the biopsy is not completelyaccurate. In addition, current biopsy devices often store the tissuesamples in one long cylindrical chamber. These samples may not beseparated in any way and contamination between samples often occurs.

[0008] In addition to these disadvantages, current biopsy devices oftenutilize a mechanical means to pull away and cut the sample. This maycreate a variation in the amount of tissue taken each time, and this canalso cause either more tissue than necessary to be taken or possibly notenough tissue to perform the desired analysis.

SUMMARY OF THE INVENTION

[0009] The advantages and purposes of the invention will be set forth inpart in the description which follows, and in part will be obvious fromthe description, or may be learned by practice of the invention. Theseadvantages and purposes will be realized and attained by way of theelements and combinations particularly pointed out in the appendedclaims.

[0010] To attain the advantages and in accordance with the purpose ofthe invention, as embodied and broadly described herein, one aspect ofthe invention is directed to an endoluminal device for taking tissuesamples. The endoluminal device for taking a plurality of tissue samplesincludes a proximal actuation mechanism attached to a distal sampler byat least one elongate member. The distal sampler includes a distal innerportion defining a plurality of chambers, each configured to receive atissue sample, and a distal outer portion defining a cutting mechanismopening having a cutting edge adjacent the cutting mechanism opening.The distal outer portion is configured so that, when the cuttingmechanism opening aligns with one of the plurality of chambers, thedistal outer portion covers the remaining chambers.

[0011] According to another aspect, the distal sampler includes achamber opening corresponding to each of the plurality of chambersthrough which the corresponding chamber can receive the tissue sample.

[0012] According to yet another aspect, the distal inner portion definesa vacuum inlet corresponding to each of the plurality of chambers, eachvacuum inlet configured to permit a vacuum to be applied to thecorresponding chamber.

[0013] In another aspect, each vacuum inlet is in fluid communicationwith a vacuum channel that is capable of communicating with a vacuumsource.

[0014] In yet another aspect, each vacuum inlet is in fluidcommunication with a separate vacuum channel to provide the vacuum tothe corresponding chamber.

[0015] According to another aspect, the proximal actuation mechanismincludes a mechanism for alternately applying the vacuum source to eachof the separate corresponding vacuum channels.

[0016] In another aspect, the cutting mechanism opening has asubstantially similar shape as each chamber opening.

[0017] According to yet another aspect, the cutting edge is configuredto sever the tissue sample as the distal outer portion moves to alignwith one of the remaining chambers.

[0018] In yet another aspect, the distal inner portion is configured tokeep a tissue sample obtained within one of the plurality of chambersseparate from tissue samples obtained within the remainder of theplurality of chambers.

[0019] According to another aspect, each of the chambers hasapproximately the same volume.

[0020] According to another aspect, one of the plurality of chambers hasa volume different from another of the plurality of chambers.

[0021] In another aspect, the distal inner portion and the distal outerportion are substantially cylindrical and substantially coaxial.

[0022] In yet another aspect, the distal outer portion is rotatablymovable relative to the distal inner portion.

[0023] According to another aspect, the plurality of sample chambers arelocated on a distal face of the distal inner portion and positionedradially about a central axis of the distal inner portion and thecutting mechanism opening is located on a distal end of the distal outerportion.

[0024] According to yet another aspect, the distal outer portion issubstantially closed at a distal end of the distal sampler andsubstantially covers the distal face of the distal inner portion.

[0025] According to another aspect, the distal face of the distal innerportion is substantially perpendicular to a longitudinal axis of thedistal inner portion.

[0026] In another aspect, the distal outer portion is axially movablerelative to the distal inner portion.

[0027] In yet another aspect, the plurality of sample chambers arelocated about a periphery of the distal inner portion and the cuttingmechanism opening is located about a periphery of the distal outerportion.

[0028] According to another aspect, the cutting edge is integral to thedistal outer portion.

[0029] In a further aspect, the distal outer portion comprises asubstantially rigid material.

[0030] In yet another aspect, the distal outer portion is materialcomprised of a rigid plastic or surgical stainless steel.

[0031] According to another aspect, the at least one elongate membercomprises a first conduit and a second conduit and the proximalactuation mechanism comprises a proximal outer portion connected to thedistal outer portion by the first conduit and a proximal inner portionconnected to the distal inner portion by a second conduit.

[0032] In another aspect, the proximal outer portion includes one ormore finger rings and the proximal inner portion includes a thumb ring.

[0033] In yet another aspect, the proximal outer portion includes afirst actuator knob and the proximal inner portion includes a secondactuator knob.

[0034] According to another aspect, the invention is directed to amethod of obtaining a plurality of tissue samples. The method includesinserting into a body lumen a biopsy device with a distal samplerdefining first and second biopsy chambers, positioning the distalsampler proximate tissue to be sampled, aligning a cutting mechanismopening with the first biopsy chamber to expose the first biopsy chamberto the tissue to be sampled while the second biopsy chamber is covered,receiving a first tissue sample into the first biopsy chamber, andsevering the first tissue sample.

[0035] According to yet another aspect, the method also includesaligning the cutting mechanism opening with the second biopsy chamber toexpose the second biopsy chamber to tissue to be sampled while the firstbiopsy chamber is covered, receiving a second tissue sample into thesecond biopsy chamber, and severing the second tissue sample.

[0036] In another aspect, the distal sampler remains in substantiallythe same position relative to the body lumen when each of the first andsecond tissue samples is severed.

[0037] In yet another aspect, the severing of the first and secondtissue samples is performed by moving a single cutting mechanismrelative to the first and second biopsy chambers respectively.

[0038] According to another aspect, the receiving of the first andsecond tissue samples into the first and second biopsy chambersrespectively includes applying a vacuum to the first and second biopsychamber respectively.

[0039] According to yet another aspect, the applying a vacuum to thefirst and second biopsy chambers includes applying the vacuum throughfirst and second vacuum inlets that correspond to the first and secondbiopsy chambers respectively.

[0040] In a further aspect, the biopsy device remains in the body lumenbetween the severing of the first tissue sample and the severing of thesecond tissue sample.

[0041] In yet a further aspect, the vacuum source is applied selectivelyto the first and second biopsy chambers by actuation of a vacuum lineselection mechanism located at a proximal end of the biopsy device.

[0042] In another aspect, the aligning comprises actuating a proximalactuation mechanism of the biopsy device to translate movement of theproximal actuation mechanism to a distal sampler of the biopsy device.

[0043] In yet another aspect, actuating the proximal actuation mechanismcomprises moving a proximal outer portion relative to a proximal innerportion to cause rotational and axial movement of a distal outer portionwith respect to a distal inner portion, and the distal outer portiondefines a cutting mechanism for severing the tissue and the distal innerportion defines the first and second biopsy chambers.

[0044] The foregoing general description and the following detaileddescription are exemplary and explanatory only and are not restrictiveof the invention as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

[0045] The accompanying drawings, which are incorporated in andconstitute a part of this specification, illustrate several embodimentsof the invention and together with the description, serve to explain theprinciples of the invention.

[0046]FIG. 1 is a plan view of a biopsy sampling device according to anembodiment of the present invention, showing a proximal actuationmechanism and a distal sampler;

[0047]FIG. 2 is a partial section view of the distal sampler of thebiopsy sampling device shown in FIG. 1;

[0048]FIGS. 3 and 4 are partial plan views of two exemplary embodimentsof an internal portion of the distal sampler shown in FIG. 2;

[0049]FIG. 5A is an end view of a distal sampler according to analternative exemplary embodiment;

[0050]FIG. 5B is a partial section view of the distal sampler of FIG. 5Ataken along section line 5B-5B;

[0051]FIG. 6 is a partial section view of another alternative embodimentof a distal sampler according to the invention;

[0052]FIG. 7 is a partial section view of an alternative embodiment ofan internal part of a distal sampler having separate vacuum lines foreach sample chamber;

[0053]FIG. 8 is a partial section view of an alternative embodiment ofan internal part of a distal sampler having separate vacuum lines foreach sample chamber;

[0054]FIG. 9 is a partial plan view of a proximal actuation mechanismaccording to an alternative embodiment of the present invention having avacuum selection device;

[0055]FIG. 10 is an end view of the vacuum line selection device of FIG.9;

[0056]FIG. 11 is a plan view of a biopsy sampling device showing aproximal actuation mechanism according to an alternative embodiment ofthe present invention;

[0057]FIG. 12 is a plan view of the distal sampler of the biopsysampling device shown in FIG. 1 in a body lumen.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0058] Reference will now be made in detail to the present preferred andexemplary embodiments of the invention, examples of which areillustrated in the accompanying drawings. Wherever possible, the samereference numbers will be used throughout the drawings to refer to thesame or like parts.

[0059]FIG. 1 depicts a sampling device 100 according to an embodiment ofthe present invention. Sampling device 100 includes a proximal actuationmechanism 101 and a distal sampler 120. Actuation mechanism 101 includesa finger ring assembly 102 that includes finger rings 103. Instead offinger ring assembly 102, it could also be possible to utilize aspool-like arrangement or any other suitable mechanism known in the art.Finger ring assembly 102 attaches to a flexible elongate member, orconnecting conduit 110. Connecting conduit 110 may be, for example, abraided tube made of nylon, polyethylene, or other suitable materialknown to one of skill in the art. Conduit 110 fixedly attaches at adistal end of sampling device 100 to an outer portion (or sleeve) 121 ofdistal sampler 120.

[0060] Actuation mechanism 101 further includes a thumb ring assembly104 that includes thumb ring 105 and extends within finger ring assembly102. Thumb ring assembly 104 translates longitudinally and rotatesrelative to finger ring assembly 102. Thumb ring assembly 104 isintegral with an elongate conduit 111 a defining a vacuum lumen 111 b.Conduit 111 a may be made of polyethylene or another suitable materialto provide a suction tube of sufficient strength so as not to collapseon itself when suction is applied. Vacuum lumen 111 b could alsocomprise a separate tube, also of sufficient strength so as not tocollapse on itself when suction is applied, extending within conduit 111b. Vacuum lumen 111 b runs from a vacuum port 106 through conduit 111 aand ultimately connects with a vacuum channel 122 located within aninner portion 123 of distal sampler 120. Vacuum port 106 is provided toallow for the sampling device to be connected to a vacuum source (notdepicted).

[0061] Conduit 111 a ultimately connects with inner portion 123 ofdistal sampler 120. In one exemplary embodiment, conduit 111 a may beintegral with portion 123, i.e. a unitary part. In the configurationshown, relative movement of finger ring assembly 102 and thumb ringassembly 104, is translated via conduits 110 and 111 a to outer portion(or sleeve) 121 and inner portion 123, respectively. Thus, as thumb ring105 rotates with respect to finger rings 103, that rotational motionwill cause inner portion 123 to rotate with respect to outer potion (orsleeve) 121. Axial motion may also translate from proximal actuationmechanism 101 to distal sampler 120 in a similar manner. As will bedescribed below, this rotational and axial motion may be used to takebiopsy samples with device 100.

[0062]FIG. 2 shows a cut-away portion of distal sampler 120. As can beseen, the vacuum channel 122 extends through a portion of inner portion123 and branches off to a plurality of sample chambers 124 via vacuuminlet ports 127. Preferably, each vacuum inlet port 127 is of asufficiently small size so that a tissue sample obtained within achamber does not exit the chamber via the vacuum inlet port 127. Vacuumchannel 122, as well as inlet ports 127, may be defined by a flexible orrigid tubing material suitable for a vacuum line located within distalsampler 120, or vacuum channel 122 and inlet ports 127 could bemanufactured as a part of distal sampler 120, such as by molding ormachining.

[0063] Outer portion 121 includes a cutting mechanism opening 125 thatincludes a cutting mechanism 126 located along at least one edge ofopening 125. Outer portion 121 may be made of surgical stainless steel,a rigid plastic or any other material suitable for medical devices.Cutting mechanism 126 may be a sharpened cutting edge of opening 125,for example, if portion 121 were made of stainless steel or any othermaterial capable of having an edge honed to a cutting sharpness. Cuttingmechanism 126 alternatively may be a pre-manufactured cutting edge thatis affixed to an edge of opening 125, for example by mechanicalfastening, welding, brazing or any other suitable manner for affixing.

[0064] As is depicted by the arrows in FIG. 2, outer portion 121 iscapable of moving both axially and rotatably with respect to innerportion 123. To allow for portion 121 to slide more easily along innerportion 123, a coating, such as a lubricant like hydrogel, could be usedbetween portion 121 and inner portion 123. In addition, in order tomaintain a seal between portion 121 and inner portion 123, especially inthe vicinity of chambers 124, sealing means such as O-rings or othersuitable sealing devices may be provided surrounding each of chambers124. Portion 121 and inner portion 123 also may be manufactured withtight tolerances to maintain proper sealing, thus eliminating the needfor additional sealing devices.

[0065] Biopsy sampling device 100 having distal sampler 120 may be usedin connection with an endoscope or other similar device. In operation,distal sampler 120 of biopsy sampling device 100 is inserted in a lumenof the endoscope that has been inserted in a patient, until distalsampler 120 reaches an area of tissue to be sampled. Distal sampler 120may then be positioned so that one or more of chambers 124 are proximatethe area of tissue to be sampled. The user may then actuate thumb ring105 with respect to finger rings 103 so as to position cutting mechanismopening 125 of outer portion 121 over one of the plurality of samplechambers 124. Once cutting mechanism opening 125 is positioned over oneof sample chambers 124, suction may be applied in the selected chamberto cause tissue to enter the chamber. Portion 121 may then be moved inan axial sliding motion relative to inner portion 123, again byactuating thumb ring 105 with respect to finger rings 103, so thatcutting mechanism 126 cuts the tissue from the patient. As portion 121moves to cut the tissue, it seals the chamber so that only the sampletaken at that time is located in the chamber.

[0066] The user then may actuate portion 121 into a position so thatopening 125 is positioned over a different chamber, by rotation, axialmovement, or both, so that a subsequent tissue sample may be captured ina similar fashion as just described. This procedure may be repeateduntil all chambers have a tissue sample or until all necessary sampleshave been obtained. As illustrated by the Figures, each retrieved samplemay be isolated within its chamber so as to reduce the possibility ofcontamination between that sample and any other samples.

[0067] While the device is shown utilizing suction to draw the tissuesample into the chamber, alternatives could be used to accomplish thistask. For example, in the case of a hanging polyp or tumor, or anysimilarly protruding segment of tissue, the distal sampler could bepositioned so that a chamber engulfs the tissue without the use FINNEGANof suction. With the tissue then inside the chamber, portion 121 couldbe moved to cut the tissue. A further alternative may include amechanical grabbing device at the base of the chamber. The mechanicalgrabbing device may have a jaw assembly or other mechanism that may beactuated at the proximal end of the biopsy sampling device by the user.This grabbing device may grasp and pull the tissue to be sampled intothe chamber so that the tissue may then be cut by the movement of theportion 121. The mechanical grabbing assembly may also be spear-likeand/or have barbs or hooks for grasping tissue and holding onto thetissue as tissue is pulled into the chamber.

[0068] The biopsy sampling device may also include indicators, such ascolor-coding or other such identification means, on portions of theproximal operator end 101. For example, axial and radial tick markscould be placed on portions of thumb ring assembly 104 and/or fingerring assembly 102 to denote relative positions of assemblies 102, 104that correspond to each of the plurality of chambers 124 located withindistal sampler 120. Each indicator can correspond to color-coding orother identification means associated with each chamber at distalsampler 120. This identification could allow the operator to relate thespecific chamber in use to that indicated at the proximal end whenremotely viewing distal sampler 120 during the procedure. For example,the user in this way may determine that he or she is viewing and workingwith the proximal-most chamber, as determined from the matchingidentification between the operator handle and the chamber.

[0069]FIG. 3 is a partial view of inner portion 123 of FIG. 2. Chambers124 and vacuum inlet ports 127 are both depicted as having a generallysquare shape. FIG. 4 shows an alternative embodiment of an interiorportion 123 a. Interior portion 123 a has circular shaped chambers 124 aand vacuum inlet ports 127 a. Although the vacuum inlet ports and samplechambers of interior portions 123, 123 a are depicted as having the sameshape, a vacuum inlet port could have a different shape from itscorresponding sample chamber. Also, although square and circular shapedchambers and inlet ports are depicted, one of ordinary skill in the artwould understand that substantially any shape could be utilized for thesample chambers and inlet ports.

[0070] In addition, each of the chambers in the distal inner portion maybe the same size and/or volume or different sizes and/or volumes toallow for different size samples to be taken. By using a vacuum to suckthe tissue sample into a chamber that is of a known volume, a moreprecise volume of tissue may be taken each time. Having sample chambersof different volumes within the same distal sampler may allow theoperator more flexibility during a given procedure by being able to takesamples of various sizes without having to remove the device from thepatient.

[0071]FIGS. 3 and 4 depict distal inner portions 123, 123 a as havingsample chambers 124, 124 a in four axial rows of three chambers equallyspaced around a periphery of inner portions 123, 123 a. Other chamberconfigurations are possible, such as more or fewer axial rows spacedequally or unequally around the periphery as well as rows containingmore or fewer than three chambers each. It could also be possible tohave axial rows containing chambers of different size within the row oreach row could contain chambers of the same size within the row, butdifferent from the size of chambers in another row or other rows. Inaddition, it could be possible to have the chambers arranged on theperiphery of the distal inner portion in a helical pattern or any otherdesired pattern. Other chamber configurations could also be possible.

[0072] As shown in FIG. 12, a distal end of a device similar to thatdepicted in FIG. 1 is positioned over a tumor 30 in a body lumen 10 suchas an intestine. A first chamber 124-1 may be exposed to the tumor 30 tobe sampled so that the tissue sample can be received into chamber 124-1.Portion 121 may then be moved so that the cutting mechanism (or cuttingedge) 126 may sever the tissue sample. An additional advantage of thistype of configuration is that with adjacent chambers 124-1 and 124-2being a predetermined distance apart, if inner portion 123 is maintainedin the same position while taking samples along the tumor 30 from thevarious chambers, the size of the tumor may be discerned. In use, thedevice can be placed with an open chamber just at the beginning of orjust before the location of the tumor. Then each successive chamber canbe used in the manner described above to remove tissue samples along thelength of the tumor concluding in a final sample that contains onlyhealthy tissue. In this manner, by counting the number of chambers thatcontain tissue from the tumor, the approximate size of the tumor can bedetermined.

[0073]FIGS. 5A and 5B show an alternative embodiment of a distal sampler220. According to this embodiment, rather than being located along theperimeter of distal sampler 220, chambers 224 are located at a distalface that is substantially perpendicular to a longitudinal axis ofsampler 220. Chambers 224 are arranged in a radial configuration aboutthe longitudinal axis of the device. An outer portion 221, rather thanbeing open-ended as in the previous embodiment, encloses and covers theend of sampler 220. A device of this type could be suitable forprocedures in larger lumens where there is more room formaneuverability, such as the stomach, where it may be possible toposition the distal face of the device proximate the area to be sampled.This configuration may also be desirable for use in other locations,such as portions of a lumen with a sharp turn where it may be difficultto navigate such that positioning the distal face of the deviceproximate the area to be sampled is easier than positioning along theside of the device. This configuration also may be used in combinationwith a device having a deflectable distal end, so that the distal faceof the distal sampler may be turned towards tissue to be sampled.

[0074] The configuration shown in FIGS. 5A and 5B differs from theprevious embodiment in that only rotational motion is necessary toaccess various of chambers 224. In operation, portion 221 could berotated such that opening 225 communicates with one of chambers 224,allowing suction to be applied to vacuum channel 222, port 227, chamber224, and ultimately to an area of tissue to be sampled. The applicationof suction may draw the tissue into chamber 224. Portion 221 then couldbe rotated again so as to allow a cutting mechanism (or cutting edge)226 to sever the tissue and opening 225 to move in position over thenext chamber. Distal sampler 220 could be repositioned to align the nextchamber with another area to be sampled, or, if the next chamber isalready in a desired location for another sample, distal sampler 220could remain in the same position for the next sample to be taken.

[0075]FIG. 6 depicts a further embodiment of a device 320 similar tothat of FIGS. 5A and 5B. In this embodiment, however, chambers are notlocated on a distal face that is substantially perpendicular to thelongitudinal axis of the device, as in FIG. 5B. Instead, chambers 324are located on a rounded, or angled, face of distal sampler 320. Portion321 is configured to substantially match the shape of inner portion 323,and is configured to be rotatable about inner portion 323. As withdistal sampler 220, distal sampler 320 has a vacuum channel 322 thatbranches into vacuum inlets 327 that communicate with each of the samplechambers 324.

[0076]FIGS. 7 and 8 depict alternative embodiments of inner portionswhereby, instead of having a single vacuum channel in communication witheach chamber via a vacuum inlet, each chamber 124, 224 is incommunication with its own vacuum channel 122, 222. Vacuum channels 122,222 may, in turn, lead to a vacuum channel selection device 315 at theproximal end of the device, as seen in FIGS. 9 and 10.

[0077]FIGS. 9 and 10 show plan and end views respectively of analternative embodiment of a proximal actuator 301 having a vacuumselection device 315, especially suited for the embodiments shown inFIGS. 7 and 8. In this embodiment, a plurality of vacuum lines 311 islocated within an inner portion 304. Each vacuum line 311 corresponds toone of the vacuum channels 122, 222 in the embodiment shown in FIGS. 7and 8. Vacuum lines 311 alternatively could be integral with vacuumchannels 122, 222, for example in the form of a tube running from vacuumselection device 315 to chambers 124, 224. Vacuum lines 311 could alsocomprise tubing that is a separate from, and connects to, vacuumchannels 122, 222. In another configuration, a portion of each of vacuumlines 311 could be formed or machined into inner portion 304 with aremainder of each of lines 311 comprising tubing that connects fromproximal inner portion 304 to distal inner portion 123, 223.

[0078] Proximal actuator 301 also has two actuator rings or knobs 303and 305. Knobs 303, 305 are affixed to outer portion 302 and innerportion 304, respectively. Outer and inner portions 302, 304 are, inturn, integral with and/or fixedly connected to outer and inner conduitsthat extend to the distal end of the device, much like conduits 110 and111 a in FIG. 1. Proximal actuator 301 operates in a generally similarfashion as the thumb/finger ring configuration of actuator 101 insofaras movement of proximal outer portion 302 relative to proximal innerportion 304 which translates to conduits 110 and 111 a and to distalouter portion 121 and distal inner portion 123. With this configuration,an operator may grasp actuator knobs 303, 305 and create both axial androtational movement of outer portion 302 relative to inner portion 304.

[0079] Vacuum selection device 315 is capable of rotational movementwith respect to knob 305 so that vacuum port 306 may align andcommunicate separately with each of vacuum lines 311. In this manner, anoperator may apply suction to each chamber independent of the otherchambers. This configuration also allows for substantially completeisolation between the various chambers.

[0080] In order to facilitate the rotation of vacuum selection device315 with respect to knob 305, proximal actuator 301 could include afeature to reversibly lock vacuum selection device 315 in place on knob305. In order to achieve this rotation without affecting the positioningof distal end 120, vacuum selection device 315 could rotate to detentpositions whereby an operator would have to grip both knob 305 andvacuum selection device 315 to select the various lines. Vacuumselection device 315 could also include a locking means that unlocks toallow for free rotation of vacuum selection device 315 with respect toknob 305 until a desired vacuum line is selected. The locking meanscould then lock vacuum selection device 315 in place over a selectedvacuum line with respect to knob 305.

[0081]FIG. 11 shows another embodiment of a biopsy sampling device. Thisembodiment includes a distal sampler 120 like that shown and describedin connection with FIG. 1. In this embodiment, however, distal sampler120 is attached to a proximal actuator 201 that is in some respects likeactuator 301 shown and described in connection with FIG. 9. Proximalactuator 201, however, communicates with a single vacuum channel 111 b,so a vacuum selection device is not needed. Proximal actuator 201includes a first actuator knob 203 connected to outer portion 202, whichin turn is connected to outer portion 121 of distal sampler 120 viaflexible conduit 110. A second actuator knob 205 connects to innerportion 104 that houses vacuum line 111 b and eventually connects viaconduit 111 a to the distal inner portion 123 of distal sampler 120.Knobs 203, 205 act as handles similar to knobs 303, 305 of actuator 301.An operator may grip knobs 203, 205 and create both rotational and axialmovement of inner portion 204 with respect to outer portion 205. Thismovement may then be translated to the distal end 120 for operation ofportion 121 with respect to inner portion 123 for biopsy purposes asdescribed above.

[0082] Other configurations for inner portion and outer portion may beused depending on the desired application. For example, the cuttingmechanism opening may be used to take samples without using a cuttingedge. In this procedure, the device could act as a head that wouldselectively open chambers to allow tissue to be sucked in. The suckingmotion alone could be sufficient to pull the tissue sample away from thepatient. Once the tissue sample is completely contained within thechamber, the distal outer portion would move, this time without cuttingany tissue, to isolate the sample in the selected chamber and proceed tothe next chamber.

[0083] Other embodiments of the invention will be apparent to thoseskilled in the art from consideration of the specification and practiceof the invention disclosed herein. It is intended that the specificationand examples be considered as exemplary only, with a true scope andspirit of the invention being indicated by the following claims.

What is claimed is:
 1. An endoluminal device for taking a plurality oftissue samples, comprising: a proximal actuation mechanism attached to adistal sampler by an elongate member, wherein the distal samplerincludes: a distal inner portion defining a plurality of chambers, eachconfigured to receive a tissue sample; and a distal outer portiondefining a cutting mechanism opening having a cutting edge adjacent thecutting mechanism opening, wherein the distal outer portion isconfigured so that, when the cutting mechanism opening aligns with oneof the plurality of chambers, the distal outer portion covers theremaining chambers.
 2. The endoluminal device of claim 1, furthercomprising a chamber opening corresponding to each of the plurality ofchambers through which the corresponding chamber can receive the tissuesample.
 3. The endoluminal device of claim 1, wherein the distal innerportion defines a vacuum inlet corresponding to each of the plurality ofchambers, each vacuum inlet configured to permit a vacuum to be appliedto the corresponding chamber.
 4. The endoluminal device of claim 3,wherein each vacuum inlet is in fluid communication with a vacuumchannel that is capable of communicating with a vacuum source.
 5. Theendoluminal device of claim 3, wherein the vacuum channel includes aplurality of discrete vacuum channels, each corresponding to and influid communication with a vacuum inlet.
 6. The endoluminal device ofclaim 5, wherein the proximal actuation mechanism includes a mechanismfor alternately applying the vacuum source to each of the discretevacuum channels.
 7. The endoluminal device of claim 2, wherein thecutting mechanism opening has a substantially similar shape as eachchamber opening.
 8. The endoluminal device of claim 1, wherein thecutting edge is configured to sever the tissue sample as the distalouter portion moves out of alignment with the one of the plurality ofchambers.
 9. The endoluminal device of claim 1, wherein the distal innerportion is configured to keep a tissue sample obtained within one of theplurality of chambers separate from tissue samples obtained within theremainder of the plurality of chambers.
 10. The endoluminal device ofclaim 1, wherein each of the chambers has approximately the same volume.11. The endoluminal device of claim 1, wherein one of the plurality ofchambers has a volume different from another of the plurality ofchambers.
 12. The endoluminal device of claim 1, wherein the distalinner portion and the distal outer portion are substantially cylindricaland substantially coaxial.
 13. The endoluminal device of claim 12,wherein the distal outer rotates movable relative to the distal innerportion.
 14. The endoluminal device of claim 13, wherein the pluralityof chambers are located on a distal face of the distal inner portion.15. The endoluimnal device of claim 14, wherein the chambers arepositioned radially about a central axis of the distal inner portion.16. The endoluminal device of claim 15, wherein the cutting mechanismopening is located on a distal face of the distal outer portion.
 17. Theendoluminal device of claim 14, wherein the distal face of the distalinner portion is substantially perpendicular to a longitudinal axis ofthe distal inner portion.
 18. The endoluminal device of clam 13, whereinthe distal outer portion is axially movable relative to the distal innerportion.
 19. The endoluminal device of claim 18, wherein the pluralityof sample chambers are located about a periphery of the distal innerportion and the cutting mechanism opening is located about a peripheryof the distal outer portion.
 20. The endoluminal device of claim 1,wherein the cutting edge is integral to the distal outer portion. 21.The endoluminal device of claim 1, wherein the distal outer portioncomprises a substantially rigid material.
 22. The endoluminal device ofclaim 1, wherein the elongate member comprises a first conduit and asecond conduit, and wherein the proximal actuation mechanism comprises aproximal outer portion connected to the distal outer portion by thefirst conduit and a proximal inner portion connected to the distal innerportion by the second conduit.
 23. The endoluminal device of claim 22,wherein the proximal outer portion includes one or more finger rings andthe proximal inner portion includes a thumb ring.
 24. The endoluminaldevice of claim 22, wherein the proximal outer portion includes a firstactuator knob and the proximal inner portion includes a second actuatorknob.
 25. A method of obtaining a plurality of tissue samples,comprising: inserting into a body lumen a biopsy device with a distalsampler defining first and second biopsy chambers; positioning thedistal sampler proximate tissue to be sampled; aligning a cuttingmechanism opening of the biopsy device with the first biopsy chamber toexpose the first biopsy chamber to the tissue to be sampled while thesecond biopsy chamber is covered; receiving a first tissue sample intothe first biopsy chamber; and severing the first tissue sample.
 26. Themethod of claim 25, further comprising aligning the cutting mechanismopening with the second biopsy chamber to expose the second biopsychamber to tissue to be sampled while the first biopsy chamber iscovered; receiving a second tissue sample into the second biopsychamber; and severing the second tissue sample.
 27. The method of claim26, wherein the distal sampler remains in substantially the sameposition relative to the body lumen when each of the first and secondtissue samples are severed.
 28. The method of claim 26, wherein thesevering of the first and second tissue samples is performed by moving asingle cutting mechanism relative to the first and second biopsychambers respectively.
 29. The method of claim 26, wherein the receivingof the first and second tissue samples into the first and second biopsychambers respectively includes applying a vacuum to the first and secondbiopsy chamber respectively.
 30. The method of claim 29, wherein theapplying a vacuum to the first and second biopsy chambers includesapplying the vacuum through first and second vacuum inlets thatcorrespond to the first and second biopsy chambers respectively.
 31. Themethod of claim 26, wherein the biopsy device remains in the body lumenbetween the severing of the first tissue sample and the severing of thesecond tissue sample.
 32. The method of claim 29, wherein the vacuumsource is applied selectively to the first and second biopsy chambers byactuation of a vacuum line selection mechanism located at a proximal endof the biopsy device.
 33. The method of claim 25, wherein the aligningcomprises actuating a proximal actuation mechanism of the biopsy deviceto translate movement of the proximal actuation mechanism to a distalsampler of the biopsy device.
 34. The method of claim 33, whereinactuating the proximal actuation mechanism comprises moving a proximalouter portion relative to a proximal inner portion to cause rotationaland axial movement of a distal outer portion with respect to a distalinner portion, wherein the distal outer portion defines a cuttingmechanism for severing tissue and the distal inner portion defines thefirst and second biopsy chambers.